Which assessment finding indicates the patient is improving during treatment for cardiogenic shock after a left ventricular MI?

Which assessment finding indicates the patient is improving during treatment for cardiogenic shock after a left ventricular MI?

• A. Central venous pressure 7 mmHg
• B. Central venous pressure 15 mmHg
• C. Systemic arterial pressure 70 mmHg
• D. Pulmonary capillary wedge pressure 25 mmHg

Answer: (A)

In cardiogenic shock from a left ventricular MI, the goal is to reduce venous congestion and improve forward flow. Central venous pressure reflects right atrial preload; when the heart’s output improves, venous pressures tend to fall toward normal. A CVP around 7 mmHg indicates preload is closer to normal and congestion is decreasing, signaling the patient is stabilizing. In contrast, a CVP of 15 mmHg shows persistent venous congestion, a systemic arterial pressure of 70 mmHg indicates ongoing poor perfusion, and a pulmonary capillary wedge pressure of 25 mmHg reveals elevated left-sided filling pressures—all consistent with continued shock. Therefore, the CVP value near normal best reflects improvement.

In cardiogenic shock from a left ventricular MI, the goal is to reduce venous congestion and improve forward flow. Central venous pressure reflects right atrial preload; when the heart’s output improves, venous pressures tend to fall toward normal. A CVP around 7 mmHg indicates preload is closer to normal and congestion is decreasing, signaling the patient is stabilizing. In contrast, a CVP of 15 mmHg shows persistent venous congestion, a systemic arterial pressure of 70 mmHg indicates ongoing poor perfusion, and a pulmonary capillary wedge pressure of 25 mmHg reveals elevated left-sided filling pressures—all consistent with continued shock. Therefore, the CVP value near normal best reflects improvement.